Friday, April 24, 2009

Fibromyalgia: brain disorder?

The Neuroscientist, Vol. 14, No. 5, 415-421 (2008)
DOI: 10.1177/1073858407312521

Fibromyalgia: A Disorder of the Brain? * Petra Schweinhardt *

Alan Edwards Centre for Research on Pain, Faculty of Dentistry, McGill

* Khara M. Sauro *

Alan Edwards Centre for Research on Pain, Faculty of Dentistry, McGill

* M. Catherine Bushnell *

Alan Edwards Centre for Research on Pain, Faculty of Dentistry, and
Department of Anesthesia, McGill University, Montreal, Quebec, Canada

This article presents evidence that fibromyalgia patients have alterations
in CNS anatomy, physiology, and chemistry that potentially contribute to the
symptoms experienced by these patients. There is substantial psychophysical
evidence that fibromyalgia patients perceive pain and other noxious stimuli
differently than healthy individuals and that normal pain modulatory
systems, such as diffuse noxious inhibitory control mechanisms, are
compromised in fibromyalgia. Furthermore, functional brain imaging
studies revealing
enhanced pain-related activations corroborate the patients' reports of
increased pain.
Neurotransmitter studies show that fibromyalgia patients
have abnormalities in dopaminergic, opioidergic, and serotoninergic systems.
Finally, studies of brain anatomy show structural differences between the
brains of fibromyalgia patients and healthy individuals. The cerebral
offer a compelling explanation for the multiple symptoms of fibromyalgia,
including widespread pain and affective disturbances. The frequent
comorbidity of fibromyalgia with stress-related disorders, such as chronic
fatigue, posttraumatic stress disorder, irritable bowel syndrome, and
depression, as well as the similarity of many CNS abnormalities,
suggests at least
a partial common substrate for these disorders. Despite the numerous
cerebral alterations, fibromyalgia might not be a primary disorder of the
brain but may be a consequence of early life stress or prolonged or severe
stress, affecting brain modulatory circuitry of pain and emotions in
genetically susceptible individuals. NEUROSCIENTIST 14(5):415-421, 2008.
DOI: 10.1177/1073858407312521

*Key Words:* Chronic widespread pain . Functional disorders . Dopamine .
Opioids . Brain morphometry


No comments: